Harms from antimicrobial overuse are significant for the frail and older adults receiving care in nursing homes. Antimicrobial stewardship programs can help protect residents from harm stemming from antibiotic overuse.
The resources below are designed to assist all nursing home healthcare professionals with implementing a stewardship program.
WA DOH Implementation Resources
Antimicrobial Stewardship Toolkit
Skilled Nursing Facility AMS Collaborative
CDC Resources
The Core Elements of Antibiotic Stewardship for Nursing Homes - Provides guidance on creating a new stewardship program.
The Core Elements of Antibiotic Stewardship for Nursing Homes: Checklist (PDF) - Checklists based upon the Core Elements resource listed above.
The Core Elements of Antibiotic Stewardship for Nursing Homes Appendices:
- Appendix A: Policy and Practice Actions to Improve Antibiotic Use (PDF)
- Appendix B: Measures of Antibiotic Prescribing, Use, and Outcomes (PDF)
- Appendix C: Data Sources, Elements, and Measures for Tracking Antibiotic Use in Nursing Homes (PDF)
Quality Improvement (QI) Tools
QI tools can assist facilities with implementing the CDC’s Core Elements for Antibiotic Stewardship in a practical manner. These tools are designed by Comagine Health.
Quick QAPI Calendar - Assists facilities with building sustained QI efforts and support. This tool is designed to be done consistently (15 minutes per day).
Plan-Do-Study-Act (PDSA) Essentials and Worksheet - Helps facilities to plan and implement small tests of change.
Root Cause Analysis (RCA) Process - Contains a workflow outlining the steps needed to perform an RCA, along with a worksheet and example.
Checklist for Sustaining Change - Aids facilities with integrating successful projects into ongoing organizational systems.
Regulations and Accreditations
Centers for Medicare and Medicaid Services State Operations Manual (PDF)
Clinical Guidance
Best Practices for Creating Local Antimicrobial Stewardship Clinical Practice Guidelines in Healthcare Settings (PDF) - Created in partnership with the University of Washington’s Centers for Stewardship in Medicine (UW-CSiM), this document assists facilities with creating local guidelines.
UW’s Centers for Stewardship in Medicine Antibiotic Treatment Guide (PDF) - Contains evidence-based antibiotic recommendations for the treatment of common diseases.
IDSA Practice Guidelines - Contains national clinical guidelines for common disease states such as pneumonia, skin infections, and urinary tract infections.
Education
Providers
PALTmed’s Urine Polymerase Chain Reaction Testing Consensus Statement - Urine polymerase chain reaction-based (PCR) laboratory testing has been promoted to clinicians as an alternative method of obtaining urine cultures. Due to the high prevalence and overuse of antibiotics for asymptomatic bacteriuria (ASB) in the post-acute and long-term setting, guidance on the topic of PCR urine testing is provided to ensure safety.
Medical Providers FAQs About Urinary Tract Infections (PDF) - An evidence-based document that addresses some common drivers for antibiotic prescribing for asymptomatic bacteriuria (ASB).
WA DOH and PALTmed WA’s Urinary Tract Infections Long-Term Care Lecture Series:
All Healthcare Professionals
WA DOH’s Communicating with Residents and Families About Antibiotics - Designed to assist with communication skills around antibiotic use, which will help avoid inappropriate prescribing.
CDC’s Educational Resources for Consultant Pharmacists - Contains posters for consultant pharmacists.
CDC’s Educational Resources for Healthcare Professionals - Contains a communication training toolkit, posters, and more.